Family history of cardiovascular disease and cardiovascular comorbidities risk in a pediatric cancer population.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10518-10518
Author(s):  
Thomas Patrick Curtin ◽  
Wendy Kohlmann ◽  
Luke Devon Maese ◽  
Zhe Yu ◽  
Karen Curtin ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Family History ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Pediatric Patients ◽  
Cvd Risk ◽  
First Degree Relatives ◽  
Pediatric Cancers ◽  
Pediatric Cancer Patients ◽  
History Of

10518 Background: Survival rates for childhood cancer patients have improved dramatically, but the growing survivor population suffers from increased treatment-related toxicity including high risk for cardiovascular disease (CVD). While the link between chemotherapy and radiation to cardiotoxicity is well established, few studies seek to determine if an underlying familial risk for cardiovascular disease contributes or predicts this risk. The Utah Population Database (UPDB) is a genealogical resource linked to statewide cancer diagnoses and electronic medical data in which family history is objectively determined. Methods: We calculated the risk of subsequent CVD (ICD-9 401-449) in relatives of 5602 pediatric cancer patients diagnosed at ages 0-19 in Utah from 1966-2013 with no congenital CVD-related anomalies (ICD-9 745-747, 758-759). We identified 964 patients with subsequent CVD diagnoses. Cox models provided recurrence-risk estimates in first-degree relatives of patients compared to relatives of 5:1 matched controls. Results: Pediatric cancer patients were at 5-fold risk of CVD compared to controls ( P< 10-15). In pediatric patients with subsequent CVD, first-degree relatives were at 30% increased CVD risk compared to relatives of cancer-free controls (HR = 1.31, 95%CI 1.16-1.47; P< 10-5). In pediatric patients without CVD, only parents exhibited slight CVD risk (HR = 1.08, 95%CI 1.03-1.14; P= 0.002). In 685,000 individuals with a non-congenital CVD history, pediatric cancers among their first-degree relatives were associated with a similar increased risk of subsequent CVD, compared to pediatric cancers among relatives of controls with no CVD events (HR = 1.39, 95%CI 1.18-1.64, P< 10-4). Conclusions: The UPDB is powerful for investigating comorbidities in cancer patients and their families without recall bias from self-reported family medical history. A family history of CVD may increase risk of CVD-related comorbidities among pediatric cancer patients by 30-40% beyond that observed in patients without a CVD family history. This finding suggests that in addition to a cancer family history, a CVD-related family history should be assessed in children diagnosed with cancer.

PSA levels in unaffected first degree relatives of prostate cancer patients are higher than in men without family history of the disease

2002 ◽  
Vol 1 (1) ◽  
pp. 75
Author(s):  
A. Valerie ◽  
L. Cormier ◽  
G. Cancel-Tassin ◽  
M. Giordanella ◽  
M. Kuntz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Family History ◽  
Cancer Patients ◽  
First Degree Relatives ◽  
History Of

Correlation of a family history of cancer with risk of relapse and death in pediatric cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 10029-10029
Author(s):  
S. L. Eichstadt ◽  
G. V. Dahl ◽  
P. G. Fisher ◽  
J. M. Ford ◽  
J. D. Schiffman
Keyword(s):  
Relative Risk ◽  
Pediatric Cancer ◽  
Pediatric Patients ◽  
Degree Relative ◽  
Risk Of Death ◽  
Increased Risk ◽  
Pediatric Cancer Patients ◽  
History Of ◽  
History Of Cancer ◽  
Risk Of Relapse

10029 Background: The association between family history of cancer (FHC) and outcome remains uncertain. Relapse and survival of children with FHC has not been well studied. Such information would be valuable for prognosis, refining treatment protocols, and long-term follow-up in pediatric patients with FHC. Methods: An historical cohort study of all pediatric patients diagnosed with cancer at Lucile Packard Children's Hospital at Stanford from 1999 - 2002 was performed (n = 363, mean age: 8.4 yrs [0–28 yrs]). FHC among 1st, 2nd and 3rd degree relatives was obtained from the first 10 consecutive encounters in the electronic medical record. Relapse, secondary malignancy, and survival data were also acquired. The relative risks for these endpoints were calculated between patients with FHC among 1st and/or 2nd degree relatives and those with negative FHC. Patients without documented FHC were excluded (n = 100). Results: 108 (41%) newly diagnosed pediatric patients had reported FHC (1st Degree: n = 14 [5%], 2nd Degree: n = 58 [22%], 3rd Degree: n = 36 [14%]). Patients with reported FHC among 1st and/or 2nd degree relatives were at increased relative risk [RR] for relapse (1.96, 95% confidence interval [CI] 1.27–3.02) compared to patients with negative FHC (n = 191). In particular, patients with Hodgkin Disease (HD) and FHC (n = 12) were more likely to relapse (RR 1.79, 95% CI 1.19–2.72) and at increased risk of death (RR 1.72, 95% CI 1.18–2.53), compared to HD with negative FHC (n = 8). Similarly, patients diagnosed with ALL and FHC (n = 22) had increased risk of death (RR 2.25, 95% CI 1.06–4.8) compared to ALL patients with negative FHC (n = 56). For patients diagnosed with any pediatric cancer and positive FHC in 1st degree relative, RR of death was significantly elevated (3.74, 95% CI 1.20–11.70). Conclusions: Pediatric cancer patients with positive FHC among 1st and/or 2nd degree relatives appear to have higher relative risk of relapse compared to those with negative FHC. Additionally, an increased risk of death was associated with HD and ALL patients with positive FHC. Patients with 1st degree relative with malignancy had an increased risk for death compared to those without cancer among 1st degree relatives. These findings may reflect underlying genetic predispositions in children which contribute to outcome. No significant financial relationships to disclose.

Hyperlipidemia Screening Is Worthwhile

PEDIATRICS ◽  
1980 ◽  
Vol 65 (3) ◽  
pp. 674-674
Author(s):  
Peter C. Freis
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Family History ◽  
Pediatric Patients ◽  
Coronary Risk Factors ◽  
Coronary Risk ◽  
Primary Physician ◽  
Premature Cardiovascular Disease ◽  
History Of

Neil A. Holtzman, MD (Hyperlipidemia screening: A search for heffalumps. Pediatrics 64:270, 1979) writes persuasively discouraging hypercholesterolemia screening and therapy in childhood. His commentary would easily dissuade the primary physician from appropriate intervention on his pediatric patients' behalf to minimize every coronary risk factor. The author unfortunately pays little attention to the children who would benefit most from hypercholesterol screening, those with a family history of premature cardiovascular disease. This is misleading. We must redirect our thinking to a continued effort to seek and minimize more appropriately coronary risk factors.

Genetic Issues

2006 ◽  
Author(s):  
Andrea Farkas Patenaude ◽  
Katherine A. Schneider
Keyword(s):  
Genetic Testing ◽  
Genetic Analysis ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Primary Malignancy ◽  
Inherited Cancer ◽  
Pediatric Cancers ◽  
Pediatric Cancer Patients ◽  
Genetic Medicine ◽  
Cancer Syndromes

The hallmark of genetic medicine is that medical concerns of one individual are germane not only for that person, but also for their offspring and future generations. Pediatric cancer patients, survivors of childhood cancers, their parents, and their siblings all have concerns that are likely to be increasingly affected by advances in genetics. It has been estimated that between 10% and 15% of pediatric cancers are either hereditary or familial in origin (Quesnel & Malkin, 1997). Advances in genetics will help identify pediatric cancers that have a hereditary origin as well as genetic syndromes, identified by other phenotypic features, which put the mutation carrier at increased risk for some types of cancer. Knowledge about hereditary cancer syndromes will help determine the risk of a second malignancy in pediatric survivors, risks of cancer in siblings, and of course, cancer risk for future offspring. To accurately estimate the risk of second primary malignancy in survivors, it is crucial to be able to identify and separate those survivors who do and do not have cancer of hereditary origin because the latter group typically faces excess risk for developing other cancers that are part of the inherited cancer syndrome. Genetic testing is currently available for several cancer syndromes that occur in childhood, most of which are relatively rare. In individual cases, predictive genetic testing may improve the likelihood that a cancer may be discovered in its early and most treatable stages. Reproductive technologies that involve genetic analysis may be important for some survivors who wish to avoid having a child with an inherited predisposition to cancer. Also, pharmacogenomics, the matching of pharmacologic treatments to patients based on genetic analysis of likely efficacy or susceptibility to adverse side effects, will likely become an important way in which genetic medicine affects pediatric cancer patients through reducing the burdens of cancer treatment. The ultimate goal of the translation of genetic findings into pediatric oncology practice is the development of targeted strategies to prevent the development of cancer. With genetic advances come questions about the ethical application of genetic technology.

Associations between family history of cardiovascular disease, knowledge of cardiovascular disease risk factors and health behaviours

2013 ◽  
Vol 19 (2) ◽  
pp. 119 ◽  
Author(s):  
Rishi Sud ◽  
Bapti Roy ◽  
Jonathan Emerson ◽  
Annemarie Hennessy
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Family History ◽  
Protective Factors ◽  
Protective Factor ◽  
Health Behaviours ◽  
Risk And Protective Factors ◽  
Strong Family History ◽  
Cvd Risk ◽  
History Of

The objective of the study was to examine associations between family history of premature cardiovascular disease (CVD), knowledge of CVD risk and protective factors, and health behaviours. The design was via administration of a questionnaire to 307 participants from four general practice centre waiting rooms in the Sydney West area. The most recognised CVD risk factor was smoking (97.7%) and the most recognised CVD protective factor was omega-3 fatty acids (78.5%). After adjustment for age, sex, education attainment and personal history of CVD, a strong family history of premature CVD was associated with being more likely to interpret a blood pressure of 130/85 as a CVD risk factor (OR 2.77, 95% CI 1.07–7.14), but less likely to identify being an ex-smoker (compared with never having smoked before) as a risk factor (OR 0.32, 95% CI 0.12–0.90). Those with a strong family history of premature CVD, on average, had smoked 0.82 pack years more than those with an average family history of premature CVD (s.e. 4.22, P = 0.04). In conclusion, there continues to be both strengths and deficits in the community’s overall knowledge of CVD risk and protective factors, and a strong family history of premature CVD appears to be an independent risk factor for smoking.

scholarly journals LINC-01. COMPLIANCE TO FOLLOW UP IN PEDIATRIC PATIENTS WHO HAVE RECEIVED CRANIOSPINAL IRRADIATION

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii378-iii378
Author(s):  
Khin Pyone ◽  
Thwe Tun ◽  
Yin Win ◽  
Aye Thinn ◽  
Khin Win ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Pediatric Cancer ◽  
Pediatric Patients ◽  
Tertiary Hospital ◽  
Craniospinal Irradiation ◽  
Long Term Effects ◽  
Pediatric Cancer Patients ◽  
Need To Evaluate

Abstract OBJECTIVE Attendance to follow-up after completion of cancer treatment is understudied area. Pediatric cancer patients have sequelae of illness or treatment. Many have no symptom immediately after completion of treatment. Long term follow-up is important to access disease control, early diagnosis of recurrence, second cancer and treatment-related morbidities. Purpose of this study was to evaluate the compliance to follow-up in pediatric patients treated with craniospinal irradiation (CSI). METHODS This was retrospective review of follow-up in pediatric neuro-oncology patients who received (CSI) from January 2017 to June 2018 in the Radiotherapy Department of Yangon General Hospital, Myanmar. RESULT: Twenty-three patients received CSI; majority (43%) were medulloblastoma. Median age was 7.5 years (3–17 years). Only seven patients (30.4%) were attended to follow-up more than 6 months after completion of treatment. More than two-thirds of patients (n=16,69.6%) were lost to follow-up. Patients in active follow-up were diagnosed and treated at earlier age below 10years (n=5,21.7%). Demographically, 5 patients (22%) were living in the region around tertiary hospital. Sixteen patients (69.6%) from rural area had limited transportation and difficulty for accommodation in which they were treated. In socioeconomic points, 18 parents (78.2%) had poor education and financial status, lack of understanding about disease, treatment, long-term effects and follow-up. CONCLUSION Although this was limited data in CSI patients only, loss to follow-up after 6 months was high. We need to evaluate in all pediatric cancer patients and collaborate to provide financial support, childcare centres for lodging, transportation and health education to promote compliance to follow-up.

Predictors of inpatient admission for pediatric cancer patients visiting the emergency department.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e22019-e22019
Author(s):  
Terrence C. Lee ◽  
Edmund M. Qiao ◽  
Alexander S. Qian ◽  
Vinit Nalawade ◽  
Rohith S. Voora ◽  
...  
Keyword(s):  
At Risk ◽  
Emergency Department ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Pediatric Patients ◽  
Bone Marrow Failure ◽  
Inpatient Admission ◽  
High Dimensional ◽  
Pediatric Cancer Patients ◽  
Icd 10

e22019 Background: Pediatric cancer patients represent a vulnerable cohort at risk of adverse outcomes after presenting to the emergency department (ED). Given the severity of cancer-related complications and uniqueness of this population, approaches to better risk stratify this cohort could potentially help define future interventions geared towards improving outcomes. We used a high-dimensional machine learning approach to help define the risk of hospitalization after an ED visit among pediatric patients with cancer. Methods: A cohort of cancer patients under 18 was identified from the Nationwide Emergency Department Sample (NEDS) between 2016-2018. We used a lasso regression model to predict inpatient admission after an ED visit. Model covariates included patient demographics, hospital characteristics, and International Classification of Diseases, version 10 (ICD-10) diagnosis codes. The data were split 75%/25% into training/testing data. The model was constructed with training data, and performance assessed on the test data using the area under the curve (AUC), with an AUC of 1.0 indicating perfect prediction. Results: We identified 129,631 pediatric cancer patients who visited the ED, of which 54.5% were subsequently admitted. The final predictive model included 150 variables, including 9 demographic, 6 hospital, and 135 unique ICD-10 codes. The model demonstrated excellent ability to predict hospitalization with an AUC of 0.96. The top 5 most important variables associated with inpatient admission were diagnoses of paralytic ileus/intestinal obstruction, neutropenia, sepsis, aplastic anemia/bone marrow failure, and bacterial infection. Conclusions: Pediatric cancer patients frequently present to the ED with complications of their cancer or their treatment, and over half of these patients are admitted. This study demonstrates the capacity of high-dimensional prediction models to help identify pediatric patients at risk of hospitalization. Additional research is needed to determine how to implement these predictive models in clinical practice.

Assessment of Oral Complications in Children Receiving Chemotherapy

2007 ◽  
Vol 31 (4) ◽  
pp. 267-273 ◽  
Author(s):  
Azza El –Housseiny ◽  
Susan Saleh ◽  
Ashraf El –Masry ◽  
Amany Allam
Keyword(s):  
Cancer Patients ◽  
Oral Mucositis ◽  
Pediatric Cancer ◽  
Pediatric Patients ◽  
Standard Dose ◽  
Dry Mouth ◽  
Oral Infections ◽  
Oral Complications ◽  
Oral Pain ◽  
Pediatric Cancer Patients

The aim of this study was to assess the early oral complications in pediatric patients receiving chemotherapy. An interview and oral examination was conducted on 150 pediatric cancer patients receiving standard dose chemotherapy. Results showed that oral pain and dry mouth were the most frequent patients' complaints. The prevalences of chemotherapy-induced oral mucositis and oral infections were relatively high. The chemotherapeutic antimetabolites were the most frequently associated with oral complications than other types of chemotherapy. The present results indicate that the oral complications among patients receiving chemotherapy are common

scholarly journals Transfusion Reactions in Pediatric Cancer Patients

2020 ◽  
Vol 7 (4) ◽  
Author(s):  
Cakra Jati Pranata ◽  
Nur Suryawan ◽  
Delita Prihatni
Keyword(s):  
Cancer Patients ◽  
Pediatric Cancer ◽  
Pediatric Patients ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
Treatment And Prevention ◽  
Pediatric Cancer Patients ◽  
Transfusion Reactions

Background: Transfusion is an essential component of supportive management for cancer patients with anemia and thrombocytopenia. It is generally safe; however, it has several risks and complications including those caused by transfusion reactions. This study aimed to describe transfusion reactions in pediatric cancer patients in a tertiary hospital in Indonesia. Methods: This was a descriptive cross-sectional study with a total sampling method. A prospective analysis was performed on episodes of blood transfusion in pediatric patients aged younger than 18 years old with cancer and were hospitalized at the Department of Child Health of the hospital from July to August 2019. After the consent of the parents, the patients were interviewed for various transfusion reactions. Data collected were presented using tables and charts. Results: Leukemia was the most frequent cancer in children cancer patients who need transfusion. Out of 42 children included, 155 episodes of transfusion were observed with 22 episodes showed transfusion reactions (14.2%). The most frequent manifestations were pruritus (31.8%), followed by combination of pruritus and erythema (27.4%) and fever (13.6%). These reactions appeared mostly in 1 to 2 hours (27.2%), with most were mild reactions (59.1%). Conclusion: Transfusion reactions mostly occurred among pediatric patients with cancer in the acute phase with clinical manifestation of allergic reactions, predominantly mild. Early identification of these reactions would result in better treatment and prevention for recurrence of transfusion reactions.

scholarly journals Prevalence of Oral Complications occurring in a Population of Pediatric Cancer Patients receiving Chemotherapy

2017 ◽  
Vol 10 (2) ◽  
pp. 166-171 ◽  
Author(s):  
Geetika Datta ◽  
Tanvi Saxena ◽  
Ankush G Datta
Keyword(s):  
Cancer Patients ◽  
Pediatric Cancer ◽  
Pediatric Patients ◽  
Lymphoblastic Leukemia ◽  
Clinical Importance ◽  
Treatment Compliance ◽  
Late Complications ◽  
Mucosal Inflammation ◽  
Oral Complications ◽  
Pediatric Cancer Patients

ABSTRACT Multiagent chemotherapy, radiotherapy, or a combination of both are the contemporary methods of cancer treatment. With medical advancements, though cure rates have increased considerably, focus is now shifted to the potential early and late complications of the same. The aim of this study was to assess the early oral complications in pediatric patients receiving chemotherapy. Sixty-two children with cancer undergoing chemotherapy with the mean age of 7.42 ± 3.6 years were included in the study. The various types of malignancies and oral problems during chemotherapy were recorded in the subjects. The most commonly encountered malignancy was acute lymphoblastic leukemia at 35.5%. Various oral and associated complications like mucosal inflammation with ulcerations, oral pain, xerostomia, and secondary infections were commonly seen, with mucositis being the most commonly observed complication in 58.1% of the subjects undergoing chemotherapy. Clinical importance of timely medical and dental interventions by a multidisciplinary team involving a pediatric dentist at different stages of anticancer treatment is also emphasized to minimize discomfort, increase treatment compliance, and improve the quality of life of pediatric patients. How to cite this article: Gandhi K, Datta G, Ahuja S, Saxena T, Datta AG. Prevalence of Oral Complications occurring in a Population of Pediatric Cancer Patients receiving Chemotherapy. Int Int J Clin Pediatr Dent 2017;10(2):166-171.

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